Few facilities and social stigma means misery for the mentally ill

World Mental Health Day means little in Bangladesh

October 10, 2012

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Today is World Mental Health Day, but it will take more than a day of awareness raising activities to alleviate conditions for mental patients in Bangladesh, who continue to suffer from inadequate facilities and social stigma. Government and private mental health facilities are paltry, with only two fully fledged state-run specialized mental hospitals with 700 beds. There are a further 813 beds in the mental health departments of the country’s state-run general hospitals. Unconfirmed sources say this supplemented by around 30 private hospitals, clinics and charitable centers that offer relevant facilities. Yet the number of adults who need this kind of help is estimated at around 1.5 million. To be a mentally impaired person in a poor country like Bangladesh, where 40 percent live below the poverty line, is nothing less than a curse. These people are generally seen as a troublesome burden by families and society and frequently thrown out of their homes. Uttara Rani, 45, recalls how her family broke apart after one of their sons was diagnosed with mental illness 10 years ago. “My husband wanted to throw him out, but I protested. Then he forced both of us out of the home,” she said. Like many people with limited education and a legacy of village superstition, she believed mental illness was an “act of the devil.” “I went to several kabiraj [exorcists] and spent a lot of money, but nothing worked,” she said. Muhammad Alam is another living example of the ostracism that a behavioral disorder can provoke. His attempts to get married have failed several times as he is considered “mad,” a description his family uses. His older brother Lutfor Rahman said Alam has “talked wildly and physically attacked people when he gets angry,” since he was 15. His family too believe him to be under the control of the devil. “For 20 years we have had village shamans treat him without any improvement. There are no mental health services in the area,” said Rahman. “But we came to Dhaka for better treatment and now he is improving.” Alam is one of the few lucky ones. Dr. Jalal Uddin of the National Institute of Mental Health estimates that about 90 percent of mental patients have no access to treatment facilities. He is also highly critical of the custom of using folk remedies. “In village areas people take patients to shamans who in fact torture them in the guise of treatment,” he said. “They beat them with brooms and make them smell burnt chilies to drive out the demons.” Dr. Belal Hossain, a private psychologist, agrees with that appraisal and says it adds a further complication: “When shamans can do nothing, that’s when people go to a doctor. By that time, the disease may be beyond control.” Holy Cross nun, Sister Nirmol Cruze supervises a Church-run mental health center in Dhaka that serves about 100 patients, free of charge. “Many families today can’t accept and even hate mentally ill children,” she said. “We believe they can improve. They can even recover if they’re treated with love and care.”

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